| NPI | 1093248916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704182286) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4714182286) |
| 363L00000X Nurse Practitioner (Licence: MI 4704182286) | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2023-04-19 |