| NPI | 1154095719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704308546) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 113726) |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2022-06-30 |