| NPI | 1912524703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1171974) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209021582) |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2026-05-13 |