| NPI | 1346826849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704326175) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704326175NSA2107P) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2021-10-06 |