| NPI | 1962718437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018013353) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209008310) |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2018-07-19 |