| NPI | 1194302091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA 61150170) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704413106) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2024-04-01 |