| NPI | 1790236321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.019725) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.019725) |
| 163W00000X Registered Nurse (Licence: IL 041.357044) | |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2025-04-10 |