| NPI | 1356378467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 145585) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 209005863) |
| 207Q00000X Family Medicine (Licence: IL 41349641) | |
| 363L00000X Nurse Practitioner (Licence: WI 11394) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 144585) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2022-11-22 |