| NPI | 1003475864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704302387) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000025683) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2024-01-19 |