| NPI | 1518211630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 22898) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704196007) |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2021-02-04 |