| NPI | 1780684340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-D02959) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041233733) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2021-03-29 |