| NPI | 1992414304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209026552) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2022043467) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2022043467) | |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2024-03-13 |