| NPI | 1760510440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-004743) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 322591) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2019-07-26 |