| NPI | 1285264564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11007168) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704317276) |
| Enumeration Date | 2020-01-25 |
| Last Update Date | 2023-10-25 |