| NPI | 1750777595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209013121) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041429144) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2015-12-30 |