| NPI | 1912246331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5019185) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209009946) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: IL 209009946) | |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2024-03-12 |