| NPI | 1275668212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209005462) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 0193960) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2021-11-04 |