| NPI | 1750691507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209007835) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 362167784) |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2010-10-14 |