| NPI | 1003639600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2026029346) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: IL 041527769) |
| Enumeration Date | 2024-11-04 |
| Last Update Date | 2026-07-02 |