| NPI | 1619212156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704242724) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 470424242724) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2024-03-06 |