| NPI | 1649652082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209029757) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.288569) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2025-04-10 |