| NPI | 1609448364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704316801) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: IN 28228728A) |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2023-05-10 |