| NPI | 1538390414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 295365) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704224923) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ 295365) | |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2024-04-18 |