| NPI | 1912539974 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9868-33) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209028989) | 
| Enumeration Date | 2020-02-07 | 
| Last Update Date | 2025-07-23 |