| NPI | 1083931570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IA H-129875) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-008094) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: WI 6380-33) | |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2015-08-05 |