| NPI | 1164275814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.029658) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 41466699) |
| Enumeration Date | 2024-04-10 |
| Last Update Date | 2024-05-15 |