| NPI | 1760802219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.011459) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209011459) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2017-02-07 |