| NPI | 1245690114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11029492) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704253720) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2024-08-01 |