| NPI | 1255787156 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209014178)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041325358)  | 
| Enumeration Date | 2016-05-10 | 
| Last Update Date | 2022-02-15 |