| NPI | 1063245496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.030673) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.477857) |
| 363L00000X Nurse Practitioner (Licence: IL 209.030673) | |
| Enumeration Date | 2024-08-21 |
| Last Update Date | 2024-11-20 |