| NPI | 1972248102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-025526) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 41350562) |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2022-07-25 |