| NPI | 1063736718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IL 209007963) |
| Additional Taxonomies | 284300000X Special Hospital (Licence: IL 209007963) |
| 282NC0060X General Acute Care Hospital, Critical Access (Licence: IL 209007963) | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2015-02-23 |