| NPI | 1154878510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 277.000664) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.295516) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.014365) | |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2022-05-10 |