| NPI | 1497399919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN236405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-031785) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5020931) | |
| 363L00000X Nurse Practitioner (Licence: IL 209-031785) | |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2025-09-23 |