| NPI | 1962507087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209007469) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 114921) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209007469) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2023-01-26 |