| NPI | 1912303900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP-02590) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 209.012021) |
| 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-02590) | |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2024-06-06 |