| NPI | 1659716181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2013011757) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2013011757) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209013526) | |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2016-09-08 |