| NPI | 1417366188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010712) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704155616) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2019-01-30 |