| NPI | 1295171270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 145635) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704225835) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2020-05-08 |