| NPI | 1639691843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704419435) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9345348) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2024-12-05 |