| NPI | 1992085583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2011001945) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 13726) |
| 363L00000X Nurse Practitioner (Licence: IL 209010030) | |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2023-06-06 |