| NPI | 1497007561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-009648) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.009648) |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2022-07-15 |