| NPI | 1275184509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704345342) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.019795) |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2022-09-13 |