| NPI | 1972486116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.036151) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041472545) |
| Enumeration Date | 2025-07-28 |
| Last Update Date | 2026-07-20 |