| NPI | 1952767253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R46991) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.013752) |
| 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9488337) | |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2018-12-31 |