| NPI | 1003513284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209029140) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 13555) |
| 363L00000X Nurse Practitioner (Licence: WI 13555) | |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2024-11-14 |