| NPI | 1770844060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.013049) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2012016691) |
| Enumeration Date | 2012-06-03 |
| Last Update Date | 2015-10-21 |