| NPI | 1316312911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307575) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704286155) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704286155) | |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2022-04-28 |