| NPI | 1639047392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209033677) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: IL 041307554) |
| Enumeration Date | 2025-10-24 |
| Last Update Date | 2025-10-27 |