| NPI | 1679090179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704262481) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704262481) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2023-09-11 |