| NPI | 1770643397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-000807) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 041-273612) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-03-12 |