| NPI | 1154799799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.012454) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: IL 041.193525) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2015-09-14 |