| NPI | 1659783314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5818) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 172706-30) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209-033389) | |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2025-10-22 |