| NPI | 1205393014 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: IL 041.322139) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.019276) | 
| Enumeration Date | 2019-02-28 | 
| Last Update Date | 2019-06-10 |