| NPI | 1750625562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209010202) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005921) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209010202) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71004297A) | |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2017-02-09 |