| NPI | 1710602206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209026285) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209026285) | |
| Enumeration Date | 2022-10-06 |
| Last Update Date | 2024-03-12 |