| NPI | 1174080618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704276084) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 43162) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: WY 43162) | |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2022-01-17 |