| NPI | 1336322007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209004400) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 198169) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 20900440) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209004400) | |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2019-01-30 |