| NPI | 1912444662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209015402) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041408591) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2017-01-19 |