| NPI | 1992177612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.013200) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5022950) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2025-11-03 |