NPI | 1316127160 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209005742) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 41349470) |
Enumeration Date | 2007-11-09 |
Last Update Date | 2007-11-09 |