| NPI | 1104697036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.029385) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.400050) |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2024-03-20 |