| NPI | 1588800700 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.007375)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209007375)  | 
| Enumeration Date | 2008-12-17 | 
| Last Update Date | 2024-07-17 |