| NPI | 1407347214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704262778) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704262778) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2020-09-23 |