| NPI | 1245889005 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019038073)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041459011)  | 
| 163W00000X Registered Nurse (Licence: MO 2005023391)  | |
| Enumeration Date | 2019-09-04 | 
| Last Update Date | 2025-08-06 |