| NPI | 1588925101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704218179) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN152416) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2018-12-14 |