| NPI | 1164723110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.008402) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209008402) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2023-10-13 |