| NPI | 1760149900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.024370) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 209.024370) |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2023-02-28 |