| NPI | 1659766012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704281339) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI F0215393) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2019-01-24 |