| NPI | 1902163942 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-009486)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2001005020)  | 
| Enumeration Date | 2012-04-16 | 
| Last Update Date | 2024-02-07 |