| NPI | 1073829461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 256725) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704212215) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2021-04-05 |