| NPI | 1700949260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: ID NP 526A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704123477) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2022-01-07 |