| NPI | 1174879084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9369193) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.009652) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 337897) | |
| Enumeration Date | 2012-07-29 |
| Last Update Date | 2015-11-24 |