| NPI | 1194680777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2026023133) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041586237) |
| 163W00000X Registered Nurse (Licence: MO 2017016488) | |
| Enumeration Date | 2025-12-17 |
| Last Update Date | 2026-05-28 |