| NPI | 1659023695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704266014) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704266014) |
| 207Q00000X Family Medicine (Licence: MI 4704266014) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704266014) | |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2023-01-25 |