| NPI | 1457785859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A107678) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.010650) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2017-04-14 |