| NPI | 1679903322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209010968) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209010968) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209010968) | |
| Enumeration Date | 2013-11-16 |
| Last Update Date | 2023-07-25 |