| NPI | 1689716995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201403724NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704285068) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2017-03-24 |