| NPI | 1154831303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209-016032) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209-016032) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209-016032) | |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2020-09-11 |