| NPI | 1598014961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704116523) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 19720) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2024-06-03 |