| NPI | 1184004178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-RN-LIC-76581) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.012144) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP127571) | |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2015-06-04 |