| NPI | 1235642919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 2017015746) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 041.457606) |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2022-07-21 |