NPI | 1144339318 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 126962) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MO 126962) |
163WG0000X Registered Nurse, General Practice (Licence: IL 041-069988) | |
363L00000X Nurse Practitioner (Licence: IL 209-003181) | |
Enumeration Date | 2006-08-30 |
Last Update Date | 2014-10-15 |