| NPI | 1972174688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.023409) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 209.023409) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.023409) | |
| Enumeration Date | 2021-07-03 |
| Last Update Date | 2022-06-15 |