| NPI | 1275007544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 1275007544) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI F01190098) |
| Enumeration Date | 2019-01-19 |
| Last Update Date | 2020-09-14 |