| NPI | 1306331830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.018168) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.366613) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2018-09-20 |