| NPI | 1063289478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209028680) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 209.028680) |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2024-03-05 |