| NPI | 1235119611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209002592) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209002592) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209002592) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2012-06-19 |