| NPI | 1649869967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209022100) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041396086) |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-01-12 |