| NPI | 1053635748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2010008797) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 2090425177) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2010008797) | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2024-01-22 |