| NPI | 1639406879 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209007723) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209007723) | 
| 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209.007723) | |
| Enumeration Date | 2009-11-09 | 
| Last Update Date | 2022-03-21 |