| NPI | 1336221852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209001076) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MO 098637) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2015-12-16 |