| NPI | 1275045973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 8896) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016440) |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2019-04-30 |