| NPI | 1104012855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 209006758) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209006758) |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2021-08-09 |