| NPI | 1639804933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209025697) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VT 026.0136967) |
| 163W00000X Registered Nurse (Licence: IL 041529120) | |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2022-08-10 |