| NPI | 1508216342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 21876) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4703102370) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2018-10-25 |