| NPI | 1780128942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2016029955) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.015105) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2016029955) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.015105) | |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2022-11-07 |