| NPI | 1700652807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.028833) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.028833) |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2026-01-10 |