| NPI | 1508245028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209012884) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209012884) |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2016-04-18 |