| NPI | 1477136638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209024332) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.440933) |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2022-03-25 |