| NPI | 1386052066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 6049-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.011643) |
| Enumeration Date | 2014-07-26 |
| Last Update Date | 2018-03-01 |