| NPI | 1174035182 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 277-004580)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71007602A)  | 
| 363L00000X Nurse Practitioner (Licence: TX 963829)  | |
| 363L00000X Nurse Practitioner (Licence: TX AP141106)  | |
| Enumeration Date | 2017-10-31 | 
| Last Update Date | 2025-10-31 |