| NPI | 1427667690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704265532) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704265532) |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2021-08-06 |