| NPI | 1609343763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209018398) |
| Additional Taxonomies | 261QC1800X (Licence: IL 209018398) |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2018-12-28 |