| NPI | 1154985414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704267626) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4204267626) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI AG07190244) | |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2023-01-30 |