| NPI | 1659840981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704422895) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0024176625) |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2025-02-21 |