| NPI | 1629457213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704274994) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704274994) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2023-01-10 |