| NPI | 1619420809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.016733) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.387329) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2017-11-22 |