| NPI | 1518549286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704329299) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704329299) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2022-03-29 |