| NPI | 1730180621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-000284) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 309002112) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2021-07-20 |