| NPI | 1154303865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704186755) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN 164653 NP) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2024-09-11 |