| NPI | 1285076646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 5456) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-296928) |
| 363L00000X Nurse Practitioner (Licence: IL 209-010940) | |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2018-01-24 |