| NPI | 1164203303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO AG08230039) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209030358) |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2024-10-02 |