| NPI | 1710489349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.017242) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2019046865) |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2023-08-01 |