| NPI | 1376505479 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277.000114) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209001718) | 
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209-001718) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 277000114) | |
| Enumeration Date | 2006-04-04 | 
| Last Update Date | 2023-08-02 |