| NPI | 1700169737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209028308) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 4595) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 4595-33) | |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2024-01-22 |