| NPI | 1477107274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 31442) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209019611) |
| 363L00000X Nurse Practitioner (Licence: IL 209019611) | |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2025-12-29 |