| NPI | 1306179379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN9334232) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.012272) |
| 363L00000X Nurse Practitioner (Licence: MO 088180) | |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2020-02-03 |