| NPI | 1124803952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-028561) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041465026) |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2024-01-15 |