| NPI | 1104259894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-010805) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041340860) |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2021-02-19 |