| NPI | 1699149211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.013449) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.429882) |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2021-06-09 |