| NPI | 1043791445 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.018233) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 041.361044) | 
| Enumeration Date | 2018-08-23 | 
| Last Update Date | 2024-09-26 |