| NPI | 1972663672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209007486) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209.007486) |
| 163W00000X Registered Nurse (Licence: IL 041-156312) | |
| 363LF0000X Nurse Practitioner Family (Licence: IL 209002628) | |
| 364S00000X Clinical Nurse Specialist (Licence: IL 209-002628) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2021-06-29 |