| NPI | 1366779639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704252943) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209008420) |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2012-08-16 |