| NPI | 1104653997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209030895) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209030895) |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2025-01-16 |