| NPI | 1679911242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: GA RN242834) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: IL 209.010450) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2018-02-01 |