| NPI | 1548366339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 309.004984) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71000171A) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2013-04-16 |