| 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 | 2018-11-09 |