| NPI | 1861775728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4789) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.009073) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2020-08-10 |