| NPI | 1619654035 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209026313) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 75875) | 
| Enumeration Date | 2023-06-28 | 
| Last Update Date | 2023-10-23 |