| NPI | 1104258961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-010592) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-346594) |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2022-12-23 |