| NPI | 1144890021 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1008990) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209023630) | 
| Enumeration Date | 2021-07-01 | 
| Last Update Date | 2023-07-10 |