| NPI | 1053865782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9453375) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704271366) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704271366) | |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2018-01-12 |