| NPI | 1356762397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 201-010836) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-010836) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209-010836) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209010836) | |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2014-04-15 |