| NPI | 1629432299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 309010247) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.257455) |
| 363L00000X Nurse Practitioner (Licence: IL 209.013723) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.013723) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2021-08-12 |