| NPI | 1801398813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2023012036) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209016579) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2023014672) | |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2023-09-11 |