NPI | 1205078383 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209007580) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-282131) |
Enumeration Date | 2009-04-03 |
Last Update Date | 2017-10-27 |