| NPI | 1053117622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.031626) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.031626) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.031626) | |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-06-03 |