| NPI | 1629476668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014036820) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209022374) |
| 363L00000X Nurse Practitioner (Licence: MO 2014036820) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209022374) | |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2023-04-03 |