| NPI | 1003405390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209014361) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041247760) |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-01-12 |