| NPI | 1003505314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.029582) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.497979) |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2025-07-12 |