| NPI | 1093287187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 227917) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041383554) |
| 363L00000X Nurse Practitioner (Licence: IL 209.018703) | |
| Enumeration Date | 2018-12-30 |
| Last Update Date | 2019-12-31 |