| NPI | 1487153367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704297171) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 382948) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2023-07-21 |