| NPI | 1912026584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209000988) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN203734) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN19281) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2022-03-17 |