| NPI | 1104436906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209022785) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 470432280) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2022-12-28 |