| NPI | 1154067783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704344185) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 2021159546) |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2022-07-01 |