| NPI | 1336564202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006777) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-031194) |
| 363L00000X Nurse Practitioner (Licence: WI 16636) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5006777) | |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2025-09-04 |