| NPI | 1508181702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-012284) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 198953) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2015-04-30 |