| NPI | 1831757103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2024000831) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 041.342889) |
| 363L00000X Nurse Practitioner (Licence: IL 209019618) | |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2024-01-18 |