| NPI | 1700809241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 78202) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209-005965) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2012-03-12 |