| NPI | 1861776486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95002298) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.009017) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2022-11-02 |