| NPI | 1902108913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209008205) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 784785) |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2015-09-16 |