| NPI | 1184317257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 1403633) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209027792) |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2023-11-28 |