| NPI | 1518475615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209017088) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.015366) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2021-03-16 |