| NPI | 1902662356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209028625) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: IL 209028625) |
| Enumeration Date | 2024-02-23 |
| Last Update Date | 2024-03-12 |