| NPI | 1326222043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5061-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209001378) |
| 363L00000X Nurse Practitioner (Licence: IL 209-001378) | |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2012-10-09 |