| NPI | 1427568732 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277001969) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209016264) |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2024-01-08 |