| NPI | 1043317381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209.010893) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MN R1640333) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-03-21 |