| NPI | 1659078624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704327741) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI F02230085) |
| Enumeration Date | 2023-02-10 |
| Last Update Date | 2024-06-08 |