| NPI | 1891205720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.016413) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.408340) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2023-01-11 |