| NPI | 1871892612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2011029157) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209008783) |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2017-06-28 |