| NPI | 1629560297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.020219) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013016271) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2022-03-01 |