| NPI | 1982791760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-005804) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 14972) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209005804) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2025-06-20 |