| NPI | 1740910900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 322872) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.482028) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.030371) | |
| Enumeration Date | 2022-06-12 |
| Last Update Date | 2025-08-30 |