| NPI | 1902391105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.024934) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041428436) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2022-04-19 |