| NPI | 1447984430 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209025416) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.025416) | 
| Enumeration Date | 2022-07-14 | 
| Last Update Date | 2022-11-09 |