| NPI | 1891726337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209-003019) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 201050069NP) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2013-06-19 |