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 |