| NPI | 1902325004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A149999) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209016466) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2024-01-18 |