| NPI | 1124073911 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IA A084351)  | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209-001288)  | 
| 363L00000X Nurse Practitioner (Licence: WI 2838)  | |
| Enumeration Date | 2006-05-23 | 
| Last Update Date | 2015-06-05 |