| NPI | 1447561600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 18691) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.008122) |
| 363L00000X Nurse Practitioner (Licence: IA A-130733) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2016-03-23 |