| NPI | 1255681029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A126090) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209009798) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2014-12-23 |