| NPI | 1023524485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.017024) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.379981) |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2020-03-02 |