| NPI | 1245719194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 470280351) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704280351) |
| Enumeration Date | 2018-08-11 |
| Last Update Date | 2023-01-05 |