| NPI | 1538677497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018006687) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041452357) |
| 163W00000X Registered Nurse (Licence: MO 143620) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209018354) | |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2019-08-29 |