| NPI | 1609508365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11014698) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209031326) |
| 363L00000X Nurse Practitioner (Licence: IA A180894) | |
| 363L00000X Nurse Practitioner (Licence: MO 2024032108) | |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2026-06-03 |