| NPI | 1093229858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209016578) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209.016578) |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2022-01-06 |