| NPI | 1164909412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209017747) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209017747) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2018-08-10 |