| NPI | 1588262513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 2020068033) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704255605) |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-12-08 |