| NPI | 1699558874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209026943) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209.026943) |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2024-07-26 |