| NPI | 1609475813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704282911) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704282911) |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2023-08-08 |