| NPI | 1720300635 |
|---|---|
| Former Name | SALLY BIRGER BOTKIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.007715) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704240094) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |