| NPI | 1164462172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209021640) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209021640) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 133125) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2024-12-04 |