| NPI | 1245824556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704314132) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704314132) |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2021-06-30 |