| NPI | 1104120641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209004401) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041249065) |
| 363LA2100X Nurse Practitioner Acute Care (Licence: IL 209004401) | |
| Enumeration Date | 2010-12-24 |
| Last Update Date | 2022-01-06 |