| NPI | 1972502292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-003995) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-197996) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2019-04-09 |