| NPI | 1487888970 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704225310) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704225310) | 
| Enumeration Date | 2009-05-12 | 
| Last Update Date | 2020-01-28 |