| NPI | 1912149337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209009880) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 16719530) |
| 163W00000X Registered Nurse (Licence: IL 041284208) | |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2013-04-29 |