| NPI | 1457609554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 277.001274) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209009753) |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2022-08-16 |