| NPI | 1700258530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704276305) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201607842NP-PP) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60712606) | |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2021-09-15 |