| NPI | 1689812638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NV APRN002410) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704231513) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2019-01-16 |