| NPI | 1316482557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.015829) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.015829) |
| Enumeration Date | 2016-12-26 |
| Last Update Date | 2017-05-07 |