| NPI | 1932734910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9947-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.020960) |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2023-03-28 |