| NPI | 1649246091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A-097512) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209005481) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2021-05-13 |