| NPI | 1144771379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704313073) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704313073) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2021-03-26 |