| NPI | 1114579323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704266845) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704266845) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2019-07-24 |