| NPI | 1073804217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209.013583) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist Adult Health (Licence: IL 209.008764) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2015-11-24 |