| NPI | 1578301115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-034291) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 242660) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 28743) | |
| Enumeration Date | 2024-07-17 |
| Last Update Date | 2026-09-03 |