| NPI | 1619342243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 340200) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704287960) |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2015-12-08 |