| NPI | 1952685620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704361398) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209010373) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2024-01-02 |