| NPI | 1104529791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.027193) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.027193) |
| 163W00000X Registered Nurse (Licence: IL 041.444584) | |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2024-09-19 |