| NPI | 1508255662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 309.008084) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209012258) |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2019-11-14 |