| NPI | 1649463811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209006605) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 041357191) |
| 363L00000X Nurse Practitioner (Licence: IL 209-006605) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2021-07-28 |