| NPI | 1679920052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.014346) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016011739) |
| 363L00000X Nurse Practitioner (Licence: IL 209.014346) | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2025-09-17 |