| NPI | 1790886257 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-010163) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 70000128a) | 
| Enumeration Date | 2006-09-26 | 
| Last Update Date | 2025-04-09 |