| NPI | 1871550004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012004957) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 041313205) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2016-05-25 |