| NPI | 1982613345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 041206732) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041206732) |
| 164W00000X Licensed Practical Nurse (Licence: IL 209002225) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2014-09-30 |