| NPI | 1720394208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.011496) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.11742-NP) |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2014-09-08 |