| NPI | 1407179955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4928) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209008031) |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2024-04-11 |