| NPI | 1538903661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.029820) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.029820) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.029820) | |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2024-06-24 |