| NPI | 1114513306 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209022951) | 
| Additional Taxonomies | 163WG0100X Registered Nurse, Gastroenterology (Licence: IL 041.411637) | 
| Enumeration Date | 2020-12-12 | 
| Last Update Date | 2023-02-14 |