| NPI | 1629354519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV 832274) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.009085) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209009085) | |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2022-10-25 |