| NPI | 1154993152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209022963) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2310538) |
| 163W00000X Registered Nurse (Licence: IL 041503529) | |
| 163W00000X Registered Nurse (Licence: CA 95195048) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2310538) | |
| Enumeration Date | 2021-07-11 |
| Last Update Date | 2022-03-21 |