| NPI | 1386102523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 15768) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704294737) |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2024-10-17 |