| NPI | 1679877047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 309.005022) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209008527) |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2019-11-14 |