| NPI | 1003471863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019021627) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2018036838) |
| 163W00000X Registered Nurse (Licence: IL 041401726) | |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2019-06-20 |