| NPI | 1649781204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: IL 209.018493) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R200071) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.018493) | |
| Enumeration Date | 2017-10-22 |
| Last Update Date | 2018-12-04 |