| NPI | 1104461045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209020392) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.020392) |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2026-05-07 |