| NPI | 1457458234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 072603) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209017488) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-03-15 |