| NPI | 1366744419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 17695) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-008465) |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2022-02-08 |