| NPI | 1316943764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 126604) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209003171) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2016-08-22 |