| NPI | 1063436533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704205095) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704205095) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2021-03-10 |