| NPI | 1811513526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209023737) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2021029244) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2023-05-16 |