| NPI | 1710532007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP021277) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013516) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704356028) | |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2020-02-01 |