| NPI | 1194412957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-84604) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209027188) |
| 363L00000X Nurse Practitioner (Licence: IL 209027188) | |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2025-09-17 |