| NPI | 1063252583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.030366) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.420596) |
| Enumeration Date | 2024-05-31 |
| Last Update Date | 2024-11-06 |