| NPI | 1154121044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.031877) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.473064) |
| Enumeration Date | 2025-03-18 |
| Last Update Date | 2025-03-19 |