| NPI | 1457020638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-034232) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 11179) |
| 363L00000X Nurse Practitioner (Licence: WI 11179-33) | |
| Enumeration Date | 2021-09-10 |
| Last Update Date | 2026-01-22 |