| NPI | 1649508714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 28142429A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041279040) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209008102) | |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2010-04-08 |