| NPI | 1164691945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 2090200077) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 150496) |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2020-04-20 |