| NPI | 1154962249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209020064) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041446344) |
| 163W00000X Registered Nurse (Licence: IN 28225021A) | |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2019-10-01 |