| NPI | 1902254584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015019129) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.014219) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-06-01 |