| NPI | 1679868996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209010140) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041580175) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 004766) | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2013-03-28 |