| NPI | 1407221484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.013632) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209013632) |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2022-12-29 |