| NPI | 1376193813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704295283) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI F09191025) |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2021-03-03 |