| NPI | 1972050623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015483) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 152313-30) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2017-03-01 |