| NPI | 1124583158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704246942) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11000685) |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2024-02-01 |