| NPI | 1699084343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704245731) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704245731) |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2019-04-05 |