| NPI | 1659106136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.030509) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 390200000X) |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2024-11-01 |