| NPI | 1396389342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209022059) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.355942) |
| Enumeration Date | 2019-11-03 |
| Last Update Date | 2020-11-03 |