| NPI | 1164402871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704163055) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168467) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2021-01-12 |