| NPI | 1881036432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2015019142) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209.010465) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: MO 2012039515) | |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2017-02-14 |