| NPI | 1558728337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 15817) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A143402) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209-014331) | |
| 163W00000X Registered Nurse (Licence: MO 2015032867) | |
| 163W00000X Registered Nurse (Licence: IL 041404031) | |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2025-02-19 |