| NPI | 1063217370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209031487) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041464807) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209031487) | |
| Enumeration Date | 2025-02-19 |
| Last Update Date | 2025-05-30 |