| NPI | 1063781664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209017283) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704248855) |
| Enumeration Date | 2011-12-28 |
| Last Update Date | 2018-06-11 |