| NPI | 1366293250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209029657) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041534445) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.029657) | |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2024-06-26 |