| NPI | 1164905014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209019323) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.379038) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2022-04-20 |