| NPI | 1083732960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9352433) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 2248) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209-004543) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-09-09 |