| NPI | 1194477158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704319995) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704319995) |
| 363L00000X Nurse Practitioner (Licence: MI 470431995) | |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2023-01-18 |