| NPI | 1578068664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209016877) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 8174-33) |
| 163W00000X Registered Nurse (Licence: IL 041335881) | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2019-05-22 |