| NPI | 1326723578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209027519) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041372719) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209027519) | |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2024-01-10 |