| NPI | 1366191355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021051162) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2002013536) |
| 163W00000X Registered Nurse (Licence: IL 041337230) | |
| Enumeration Date | 2022-03-18 |
| Last Update Date | 2022-05-17 |