| NPI | 1639380447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 061769) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: MO 061769) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209-004555) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2011-05-12 |