| NPI | 1740914894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209025545) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.444908) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-09-14 |