| NPI | 1194278622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN268084) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704284970) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704284970) | |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2019-11-22 |