| NPI | 1962980979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209017735) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018012503) |
| 163WG0000X Registered Nurse, General Practice (Licence: IL 041453981) | |
| 163WG0000X Registered Nurse, General Practice (Licence: MO 2002007982) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209017735) | |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2025-09-19 |