| NPI | 1205343357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209016925) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 209016925) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016925) | |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2021-12-01 |