| NPI | 1467646562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 5547) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-001119) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2018-03-17 |