| NPI | 1710365176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209012818) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209012818) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2025-01-22 |