| NPI | 1568996650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704327851) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704327851) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704327851-4343037) | |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2023-04-18 |