| NPI | 1942968839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.025053) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041396326) |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2022-11-09 |