| NPI | 1255806014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704298084) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704298084) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2018-12-01 |