| NPI | 1134680309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704297379) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704297379) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2022-09-20 |