| NPI | 1972149698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11008817) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 432491) |
| 163W00000X Registered Nurse (Licence: FL 9527190) | |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2021-10-04 |