| NPI | 1972607513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-004285) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-138211) |
| 163W00000X Registered Nurse (Licence: WI 142938-030) | |
| 363L00000X Nurse Practitioner (Licence: WI 2181) | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2013-04-19 |