| NPI | 1104392497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209018213) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.018213) |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2023-09-15 |