| NPI | 1619196797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 119797) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 309-002288) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2013-01-24 |