| NPI | 1710306725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209011448) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 8393-33) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2022-12-23 |