| NPI | 1992246763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.015738) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.404505) |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2024-05-16 |