| NPI | 1073713913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7504) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209005063) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2017-08-22 |