| NPI | 1760162531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.028151) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.547551) |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2023-09-28 |