| NPI | 1205050622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.009825) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DC RN56494) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: DC RN56494) | |
| 363L00000X Nurse Practitioner (Licence: CO APN.005688-NP) | |
| 163W00000X Registered Nurse (Licence: CO RN.0185938) | |
| 163W00000X Registered Nurse (Licence: IL 041.392729) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2015-09-14 |