| NPI | 1659855013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704289629) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704289629) |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2019-02-11 |