| NPI | 1790154169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9430779) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209013223) |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2018-12-04 |