| NPI | 1144942624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209025950) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: LA 235130) |
| Enumeration Date | 2022-09-13 |
| Last Update Date | 2025-01-30 |