| NPI | 1821691759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209022235) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209022235) |
| 163W00000X Registered Nurse (Licence: IL 01414132) | |
| Enumeration Date | 2020-11-21 |
| Last Update Date | 2024-04-09 |