| NPI | 1790371094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 1670333) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.022502) |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2025-08-03 |