| NPI | 1992085583 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2011001945)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AR 227739)  | 
| 363L00000X Nurse Practitioner (Licence: IA H178193)  | |
| 363L00000X Nurse Practitioner (Licence: KS 53-82876-102)  | |
| 363L00000X Nurse Practitioner (Licence: WI 13726)  | |
| 363L00000X Nurse Practitioner (Licence: IL 209010030)  | |
| Enumeration Date | 2011-08-26 | 
| Last Update Date | 2025-05-28 |