| NPI | 1265167597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704342105) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.489002) |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2025-05-06 |