| NPI | 1427682582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.020938) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.428993) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.020938) | |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-06-08 |