| NPI | 1548796964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704258315) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 470258315) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2024-07-30 |