| NPI | 1114713146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.033382) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041514411) |
| 163W00000X Registered Nurse (Licence: MN 2465297) | |
| Enumeration Date | 2025-04-16 |
| Last Update Date | 2025-09-29 |