| NPI | 1659929081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704265114) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI F08190336) |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2021-11-08 |