| NPI | 1700591724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704402365) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 227728) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 32770) | |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2023-09-15 |