| NPI | 1629759006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209030870) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-030870) |
| 163W00000X Registered Nurse (Licence: IL 041388718) | |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2026-01-21 |