| NPI | 1912776022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209029111) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2025033731) |
| Enumeration Date | 2023-12-29 |
| Last Update Date | 2025-09-02 |