| NPI | 1578990032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209015367) |
| Additional Taxonomies | 286500000X Military Hospital |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2022-03-30 |