| NPI | 1780062299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A122492) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209012668) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA A122492) | |
| Enumeration Date | 2015-05-16 |
| Last Update Date | 2018-09-13 |