| NPI | 1669036331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 260933) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.01855) |
| Enumeration Date | 2019-04-27 |
| Last Update Date | 2026-03-02 |