| NPI | 1336959568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209031383) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.420849) |
| 363L00000X Nurse Practitioner (Licence: IL 209.031383) | |
| Enumeration Date | 2025-01-09 |
| Last Update Date | 2025-06-12 |