| NPI | 1568253714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.033245) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.498303) |
| Enumeration Date | 2025-05-16 |
| Last Update Date | 2025-09-16 |