| NPI | 1508431503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209022919) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 1149333) |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2023-02-01 |