| NPI | 1568983765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209.016112) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: IL 209.016112) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2020-10-09 |