| NPI | 1972837888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209003793) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: IL 209003793) |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2009-09-24 |