| NPI | 1275963290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 041.370895) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 041.370895) |
| 363L00000X Nurse Practitioner (Licence: IL 209011078) | |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2016-11-03 |