| NPI | 1154937654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704328169) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI F07201912) |
| Enumeration Date | 2020-09-20 |
| Last Update Date | 2024-07-31 |