| NPI | 1104407691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704232661NSA2109F) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4704232661) |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2022-01-02 |