| NPI | 1598202897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-014405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 209014405) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2018-06-20 |