| NPI | 1053979310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704348421) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 25894) |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2022-09-14 |