| NPI | 1780227124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.020473) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041390906) |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-11-18 |