| NPI | 1811587314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209025758) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.454524) |
| 363LF0000X Nurse Practitioner Family (Licence: IL 209.025758) | |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2025-02-19 |