| NPI | 1982883914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 041.262920) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 041-262920) |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2011-11-14 |