| NPI | 1477136034 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.023733)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041435671)  | 
| Enumeration Date | 2021-05-03 | 
| Last Update Date | 2024-09-27 |