| NPI | 1710266903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-008935) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 14655) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2024-07-01 |