| NPI | 1629043849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 133429) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209000687) |
| 363L00000X Nurse Practitioner (Licence: MO 133429) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2016-11-08 |