| NPI | 1538884804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704353006) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI F09220992) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2022-12-16 |