| NPI | 1801534607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209025853) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041431912) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209025853) | |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2022-12-08 |