| NPI | 1114630886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209026619) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.026619) |
| Enumeration Date | 2022-12-27 |
| Last Update Date | 2024-05-22 |