| NPI | 1679977631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.012030) |
| Additional Taxonomies | 163WX0800X Registered Nurse, Orthopedic (Licence: IL 041.379684) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2014-10-20 |