| NPI | 1407397284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209015741) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.015741) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209015741) | |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2024-03-01 |