| NPI | 1407005119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5004033) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-031918) |
| 363L00000X Nurse Practitioner (Licence: WI 16737) | |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2025-07-29 |