| NPI | 1609608090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.030756) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.499075) |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2024-10-10 |