| NPI | 1801292404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.012092) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041382461) |
| Enumeration Date | 2014-11-08 |
| Last Update Date | 2014-11-08 |