| NPI | 1083440457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024039031) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2024037599) |
| 163W00000X Registered Nurse (Licence: IL 041.447832) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.030308) | |
| Enumeration Date | 2024-09-11 |
| Last Update Date | 2024-12-11 |