| NPI | 1609393479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016292) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.379255) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |