| NPI | 1770030801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-014991) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041343459) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-10-21 |