| NPI | 1679392591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2026011150) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.035290) |
| Enumeration Date | 2024-10-08 |
| Last Update Date | 2026-05-06 |