| NPI | 1104612571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.033118) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041571182) |
| Enumeration Date | 2025-04-15 |
| Last Update Date | 2025-09-04 |