| NPI | 1629490859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209010943) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209010943) |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2016-01-28 |