| NPI | 1962295659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95038142) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.034383) |
| 163W00000X Registered Nurse (Licence: IL 041.420667) | |
| Enumeration Date | 2025-05-26 |
| Last Update Date | 2026-07-08 |