| NPI | 1508464736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.022845) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.440376) |
| Enumeration Date | 2020-10-10 |
| Last Update Date | 2021-02-10 |