| NPI | 1255428793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 0371998) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 041333443) |
| 363L00000X Nurse Practitioner (Licence: IL 209004753) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2022-02-04 |