| NPI | 1639685134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.017246) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041382958) |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2018-09-25 |