| NPI | 1255680500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704269320) |
| Additional Taxonomies | 163WC1500X Registered Nurse Community Health (Licence: CO 190380) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2023-11-30 |