| NPI | 1861939613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209.015437) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: IL 209.015437) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2017-01-31 |