| NPI | 1679941546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 041567282) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 264555) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5008050) | |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2025-09-19 |