| NPI | 1225514722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209017864) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2018016871) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |