| NPI | 1710402714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 7853-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704317913) |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2018-06-06 |