| NPI | 1538323456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209008189) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 334729) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2014-04-10 |