| NPI | 1205312790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209017970) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 041.415297) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-11-09 |