| NPI | 1548664170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: IL 209011964) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209011964) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2014-10-10 |