| NPI | 1063183952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN308064) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.024022) |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2025-05-20 |