| NPI | 1710420534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 47042765555) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704276555) |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2019-01-04 |