| NPI | 1942951553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 13196457-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.520054) |
| 163W00000X Registered Nurse (Licence: WI 25634630) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209026151) | |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2024-07-05 |