| NPI | 1780454389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2023037394) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2023037394) |
| 163W00000X Registered Nurse (Licence: MO 2016023237) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209029415) | |
| Enumeration Date | 2024-01-04 |
| Last Update Date | 2025-09-17 |