| NPI | 1619409133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016007) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041362828) |
| 363L00000X Nurse Practitioner (Licence: IL 209016007) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-11-14 |