| NPI | 1669838496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209030955) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 6647) |
| Enumeration Date | 2016-01-09 |
| Last Update Date | 2025-07-28 |