| NPI | 1225202492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209006891) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209006891) |
| 164W00000X Licensed Practical Nurse (Licence: IL 209006891) | |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2018-10-19 |