| NPI | 1891260667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209018297) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209.018297) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2021-08-09 |