| NPI | 1164814711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209012500) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.012500) |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2026-04-22 |