| NPI | 1962942532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015429) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041420283) |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-03-02 |