| NPI | 1003688839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209028542) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: IL 041.455121) |
| Enumeration Date | 2023-10-25 |
| Last Update Date | 2024-01-09 |