| NPI | 1063185072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704300662) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704300662NSA210LV) |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2024-04-17 |