| NPI | 1164205506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209031013) |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2024-11-22 |