| NPI | 1124486790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209013707) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209013707) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209013707) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209013707) | |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2018-12-19 |