| NPI | 1790422780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.026004) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041444579) |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2023-06-11 |