| NPI | 1861628703 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-008385)  | 
| Additional Taxonomies | 364SE0003X Clinical Nurse Specialist, Emergency (Licence: IL 209-004791)  | 
| Enumeration Date | 2009-06-05 | 
| Last Update Date | 2021-12-16 |