| NPI | 1306470729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704345902) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 33546) |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2022-01-04 |