| NPI | 1104658368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024195503) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209030291) |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2026-08-03 |