| NPI | 1205311677 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 112248-23) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.018059) | 
| Enumeration Date | 2018-10-01 | 
| Last Update Date | 2025-10-29 |