| NPI | 1790313955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704380358) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041441464) |
| 363L00000X Nurse Practitioner (Licence: IL 209021108) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2022-10-25 |