| NPI | 1235752742 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209026291)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 14900579)  | 
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209026291)  | |
| Enumeration Date | 2020-05-19 | 
| Last Update Date | 2023-10-05 |