| NPI | 1609395383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.016427) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 041.386529) |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2017-09-14 |