| NPI | 1104374271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016034577) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-83602-082) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209022442) | |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2026-02-02 |