| NPI | 1194149302 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209010815) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041355848) | 
| Enumeration Date | 2014-02-07 | 
| Last Update Date | 2018-12-03 |