| NPI | 1689169088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A136194) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.415982) |
| 363L00000X Nurse Practitioner (Licence: IL 209.017749) | |
| 163W00000X Registered Nurse (Licence: IA 136194) | |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2026-07-08 |