| NPI | 1659523710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 4494) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209007299) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2018-03-17 |