| NPI | 1376963074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704267818) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95011073) |
| 363L00000X Nurse Practitioner (Licence: IL 209011486041419613) | |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2023-07-31 |