| NPI | 1306405618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704240877) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704240877) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704240877) | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2023-05-30 |