| NPI | 1922512458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209016884) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209.016884) |
| 163W00000X Registered Nurse (Licence: IL 041.402891) | |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2021-06-07 |