| NPI | 1730284670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201150152NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209002092) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2013-04-11 |