| NPI | 1215605217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704276588) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 2021036445) |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2021-11-05 |