| NPI | 1710374988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209012390) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.365598) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2021-04-06 |