| NPI | 1669123212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209026631) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001296435) |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2024-08-05 |