| NPI | 1578039707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209.018461) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.394076) |
| 207N00000X Dermatology (Licence: IL 209018461) | |
| 363L00000X Nurse Practitioner (Licence: IL 209018461) | |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2019-11-07 |