| NPI | 1497021810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2012001249) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012001249) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2020037590) | |
| 363L00000X Nurse Practitioner (Licence: IL 277000588) | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2025-09-19 |