| NPI | 1396282554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.015291) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.015291) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.015291) | |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2017-01-26 |