| NPI | 1407173412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9305-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041337048) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209008118) | |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2021-01-13 |