| NPI | 1174873806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R225341) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209009818) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 337293) | |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2021-08-16 |