| NPI | 1134742802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704337446) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA 145422) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2022-11-18 |