| NPI | 1023393311 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A160608)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209009134)  | 
| Enumeration Date | 2011-10-18 | 
| Last Update Date | 2025-04-07 |