| NPI | 1306367255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175923) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704299915) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2024-02-12 |