| NPI | 1194108654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60834865) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA RN60834415) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209012782) | |
| 163W00000X Registered Nurse (Licence: IL 041397288) | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2022-10-13 |