| NPI | 1720515398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2016039777) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209023299) |
| 363L00000X Nurse Practitioner (Licence: MO 201603977) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2016039777) | |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2022-01-26 |