| NPI | 1669978383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704294266) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11001768) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2021-11-13 |