| NPI | 1013397967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209012521) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2014040193) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2017-01-23 |