| NPI | 1194776153 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704138423) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9217571) | 
| Enumeration Date | 2006-05-15 | 
| Last Update Date | 2024-09-26 |