| NPI | 1295342913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704378073) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: UT 10941553-4405) |
| Enumeration Date | 2020-09-27 |
| Last Update Date | 2022-04-14 |