| NPI | 1164617379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R164999) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704339284) |
| 207Q00000X Family Medicine (Licence: MD R164999) | |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2024-09-23 |