| NPI | 1750161857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209031131) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 14595-033) |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2025-01-13 |