| NPI | 1245940907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3018747) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704390501) |
| Enumeration Date | 2022-12-02 |
| Last Update Date | 2024-01-12 |