| NPI | 1962056234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277001905) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11002561) |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2024-12-19 |