| NPI | 1467654772 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209007047)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209007047)  | 
| 163WG0600X Registered Nurse, Gerontology (Licence: IL 209007047)  | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209007047)  | |
| Enumeration Date | 2007-05-31 | 
| Last Update Date | 2023-11-06 |