| NPI | 1487749578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI Practitioner 4704162) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704162975) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2019-09-11 |