| NPI | 1871216374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209025801) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2022-09-21 |