| NPI | 1538260856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704214400) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 263300970) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2023-11-20 |