| NPI | 1770893158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209.008359) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 041246820) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2018-02-05 |