| NPI | 1861744575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209009869) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 25770) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2022-03-18 |