| NPI | 1639693617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-016457) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-402043) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2021-03-04 |