| NPI | 1669211504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.031192) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.475282) |
| Enumeration Date | 2024-05-21 |
| Last Update Date | 2025-07-03 |