| NPI | 1033777909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.020106) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2210665) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2019-09-25 |