| NPI | 1023414083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125079384) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9250915) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.079384) | |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2022-09-04 |