| NPI | 1740364355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 450504) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 041164136) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2008-07-27 |