| NPI | 1023328226 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-016202)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 4227)  | 
| Enumeration Date | 2010-10-21 | 
| Last Update Date | 2018-03-17 |