| NPI | 1962410191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-001494) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209-001494) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2013-11-20 |