NPI | 1144694639 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209013080) |
Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: IL 209013080) |
302R00000X Health Maintenance Organization (Licence: IL 209013080) | |
305R00000X Preferred Provider Organization (Licence: IL 209013080) | |
305S00000X Point of Service (Licence: IL 209013080) | |
363LF0000X Nurse Practitioner, Family (Licence: IL 209013080) | |
Enumeration Date | 2015-11-20 |
Last Update Date | 2022-03-15 |