| NPI | 1356930283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704322609) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: NC 233944) |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2022-01-16 |