| NPI | 1225417876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.015993) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN161827) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2018-07-16 |