| NPI | 1790499580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209026658) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.026658) |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2025-12-08 |