| NPI | 1417654922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704321104) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 13499241-4405) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ 296952) | |
| Enumeration Date | 2023-02-14 |
| Last Update Date | 2023-09-06 |