| NPI | 1124493598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008234) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.013154) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-10 |