| NPI | 1922478726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.015739041.450382) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2012018659) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2020-04-14 |