| NPI | 1265036164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209019817041359232) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209019817) |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2020-12-04 |