| NPI | 1063165017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.024945) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: IL 041368468) |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2022-04-12 |