| NPI | 1639546062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025011330) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209013087) |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2025-07-24 |