| NPI | 1235641804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 8929) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209016700) |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2019-01-17 |