| NPI | 1639145006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168529) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041317123) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2010-11-11 |