| NPI | 1861799090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 28112202A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 041.301282) |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2011-11-30 |