| NPI | 1114583192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704295698) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704295698NSA190CJ) |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2022-10-19 |