| 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 |