| NPI | 1285966739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2009038222) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209017441) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2009038222) | |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2022-07-05 |