| NPI | 1639904006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209030724) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.030724) |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2024-10-17 |