| NPI | 1619531753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.018571) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.389857) |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2019-04-24 |