| NPI | 1255664447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-010613) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 3825-033) |
| 363L00000X Nurse Practitioner (Licence: WI 3825) | |
| Enumeration Date | 2009-09-07 |
| Last Update Date | 2023-04-26 |