| NPI | 1235353673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5004422) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209031632) |
| 363L00000X Nurse Practitioner (Licence: WI 16806) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5004422) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2025-09-16 |