| NPI | 1023662236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704300512) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI F07190403) |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2021-05-17 |