| NPI | 1912662651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209024371) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041460053) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.024371) | |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2022-01-04 |