| NPI | 1386950400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2004004963) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209008365) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2021-11-17 |