| NPI | 1689027344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7056-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-016098) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 7056-33) | |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2018-08-30 |