| NPI | 1811302409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-011916) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-328608) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2021-03-16 |