| NPI | 1639303761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.007543) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F307149) |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2017-03-28 |