| NPI | 1164105490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2024035390) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 0041488224) |
| 163W00000X Registered Nurse (Licence: MO 2019000479) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209030058) | |
| Enumeration Date | 2023-08-11 |
| Last Update Date | 2024-12-06 |