| NPI | 1154748648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209011405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014004552) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2014-03-24 |