| NPI | 1164129458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209027158) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041459161) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.027158) | |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2024-10-21 |