| NPI | 1063818813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 209011913) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.011913) |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2022-03-16 |