| NPI | 1942655865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6958-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.014255) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.014255) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.014255) | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2022-11-15 |