| NPI | 1508060518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 277-000416) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-006380) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.006380) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2021-02-18 |