| NPI | 1386254464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 309739) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.021802) |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2023-07-13 |