| NPI | 1790214930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-015944) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.015944) |
| Enumeration Date | 2017-06-10 |
| Last Update Date | 2025-10-30 |