| NPI | 1063064129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209022608) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 344728) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2023-02-15 |