| NPI | 1932527900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704324682) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209011118) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704324682) | |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2018-12-05 |