| NPI | 1588242705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704307317) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704307317NSA2108I) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2022-10-24 |