| NPI | 1558976589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.021989) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.021989) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.021989) | |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2021-03-23 |