| NPI | 1548899917 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209021193)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041424540)  | 
| 163W00000X Registered Nurse (Licence: MI 4704281881)  | |
| Enumeration Date | 2020-04-07 | 
| Last Update Date | 2021-09-17 |