| NPI | 1932459617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209009769) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209009769) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2020-05-08 |