| NPI | 1164005971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704420364) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IN 71011090A) |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2024-09-05 |