| NPI | 1861705717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209.009082) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.396801) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MA 2262499) | |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2011-12-07 |