| NPI | 1093055782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A170330) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-010374) |
| Enumeration Date | 2013-02-18 |
| Last Update Date | 2022-09-16 |