| NPI | 1215263983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4037) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ TRN168122) |
| 363L00000X Nurse Practitioner (Licence: IL 209.007758) | |
| Enumeration Date | 2009-10-30 |
| Last Update Date | 2020-06-01 |