| NPI | 1629435060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704276415) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209013548) |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2019-02-06 |