| NPI | 1033460084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005891) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209032587) |
| 363L00000X Nurse Practitioner (Licence: WI 16912) | |
| Enumeration Date | 2012-09-29 |
| Last Update Date | 2026-02-05 |