| NPI | 1205571767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.025595) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.459118) |
| Enumeration Date | 2022-04-29 |
| Last Update Date | 2024-06-10 |