| NPI | 1033507975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.012211) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.360584) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2015-09-08 |