| NPI | 1326567173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209016150) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-377098) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209-016150) | |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2022-06-06 |