| NPI | 1356378467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 145585) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 11394) |
| 363L00000X Nurse Practitioner (Licence: IL 209005863) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2025-03-13 |