| NPI | 1407495161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI F12190523) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704262494) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704262494) | |
| Enumeration Date | 2019-12-29 |
| Last Update Date | 2022-06-16 |