| NPI | 1245668532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95004680) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209010857) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2017-01-17 |