| NPI | 1780140301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2372503) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041411612) |
| 363L00000X Nurse Practitioner (Licence: IL 209019073) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209019073) | |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2023-02-08 |