| NPI | 1770045049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209019124) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71010167A) |
| 163W00000X Registered Nurse (Licence: IL 041404716) | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2023-08-30 |