| NPI | 1407163165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007350) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.008282) |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2019-02-14 |