| NPI | 1073845517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704230713) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 77380) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704230713) | |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2024-01-11 |