| NPI | 1770093171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.016571) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016571) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2022-02-15 |