| NPI | 1609926088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209026246) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180-005510) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11021349) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2022-10-25 |