| NPI | 1790517324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: IL 209.030171) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704316399) |
| 163W00000X Registered Nurse (Licence: IL 041.517979) | |
| Enumeration Date | 2024-08-14 |
| Last Update Date | 2024-08-14 |