| 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 |