| NPI | 1154555852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.007447) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.331106) |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2009-05-08 |