| NPI | 1679026892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI F06161957) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704301068) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2019-02-11 |