| NPI | 1710621289 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209025079)  | 
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: IL 209025079)  | 
| Enumeration Date | 2022-04-21 | 
| Last Update Date | 2025-04-16 |