| NPI | 1700667292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.027663) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11024264) |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2023-10-10 |