| NPI | 1205406618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209023402) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209.0402) |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2021-12-08 |