| NPI | 1629079280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 277000619) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 209005521) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA T058429) | |
| 363LF0000X Nurse Practitioner Family (Licence: IA A058429) | |
| 363LF0000X Nurse Practitioner Family (Licence: IL 209005785) | |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2020-11-10 |