| NPI | 1013677699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2013031821) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209024973) |
| 363L00000X Nurse Practitioner (Licence: MO 2020029114) | |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2025-08-07 |