| NPI | 1700252822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209013058) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 350128) |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2023-10-25 |