| NPI | 1902554306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 277.003818) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A167920) |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2025-02-05 |