| NPI | 1306828140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-005558(41-307571) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4447P) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2016-08-30 |