| NPI | 1477817138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.009563) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.350457) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2014-03-03 |