| NPI | 1063957348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.015151) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209.015151) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2020-06-23 |