| NPI | 1205373461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.016052) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28203094A) |
| 163W00000X Registered Nurse (Licence: IL 041.453404) | |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2022-12-16 |