| NPI | 1376286393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704319910) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704319910) |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2022-10-27 |