| NPI | 1780050062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-016949) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 6574) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2023-07-12 |