| NPI | 1225656432 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 277003499) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: IL 041399309) |
| 163WE0003X Registered Nurse, Emergency (Licence: CA 95236442) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95016336) | |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2024-12-05 |