| NPI | 1003547308 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 041.517060) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN |
| Enumeration Date | 2022-06-18 |
| Last Update Date | 2025-01-27 |