| NPI | 1710424965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 20250009807) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015510) |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2025-09-17 |