| NPI | 1376052654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704300719) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704300719) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: MI 4704300719) | |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2019-05-23 |