| NPI | 1689110850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.015543) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.015543) |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2017-02-09 |