| NPI | 1629506175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9476985) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9476985) |
| 363L00000X Nurse Practitioner (Licence: MI 4704284945) | |
| Enumeration Date | 2017-05-29 |
| Last Update Date | 2024-03-20 |