| NPI | 1619180064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704299051) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IL A0307202) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-12-18 |