| NPI | 1326646365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704325666) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 20197100234) |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-11-02 |