| NPI | 1982216909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.021810) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.021810) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.021810) | |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2022-03-09 |