| NPI | 1912539974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209028989) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 9868-33) |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2024-03-26 |