| NPI | 1952959686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9557) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.019907041.427470) |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2025-10-13 |