| NPI | 1902217540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209011350) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 13397-30) |
| 363L00000X Nurse Practitioner (Licence: MO 2015018041) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209011350) | |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2023-10-04 |