| NPI | 1255941928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209019888) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.019888) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2020-12-22 |