| NPI | 1114308251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209011572) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1018533) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2021-09-24 |