| NPI | 1487209045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209023042) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2019025808) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2019025808) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209023042) | |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2021-10-14 |