| NPI | 1104516293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: IL 209-027051) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-027051) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209027051) | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: IL 209027051) | |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: IL 209027051) | |
| Enumeration Date | 2023-05-11 |
| Last Update Date | 2025-04-02 |