| NPI | 1114647039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209026485) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2022015303) |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2025-12-22 |