| NPI | 1902212608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71015147A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2014021871) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.012733) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2014021871) | |
| 363L00000X Nurse Practitioner (Licence: IL 209.012733) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2024-12-19 |