| NPI | 1902337553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2016044501) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.342111) |
| 163W00000X Registered Nurse (Licence: MO 126320) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 20901523) | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-03-24 |