| NPI | 1154520195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9116-33) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CO 105339) |
| 363L00000X Nurse Practitioner (Licence: IL 209-018593) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209.018593) | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2019-03-26 |