| NPI | 1245203272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2000167712) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209005424) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-11-04 |