| NPI | 1609943661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209-000619) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2024043024) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 2024043024) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2025-01-22 |