| NPI | 1376276022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: IL 209025320) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041375169) |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2022-08-02 |