| NPI | 1518411081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209014862) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209.014862) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2020-09-03 |