| NPI | 1225398316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP95003555) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.009557) |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2019-03-12 |