| NPI | 1376188110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209022504) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041422080) |
| 363LF0000X Nurse Practitioner Family (Licence: IL 2020089466) | |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2022-10-20 |