| NPI | 1124401799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 201603126NP) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209012825) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2016-10-04 |