| NPI | 1578574802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 41-155407) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-002843) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2007-07-08 |