| NPI | 1023120797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209-000751) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 148611) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-06-29 |