| NPI | 1124190590 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209030215) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 120113) | 
| 363LF0000X Nurse Practitioner, Family (Licence: NE 110580) | |
| Enumeration Date | 2006-11-14 | 
| Last Update Date | 2025-10-01 |