| NPI | 1912514274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 17656) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 17656-33) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5015425) | |
| 363L00000X Nurse Practitioner (Licence: IL 209.033951) | |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2025-12-29 |