| NPI | 1386954063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704253116) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MI 1386954063) |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2022-11-03 |