| NPI | 1720417694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704235673) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171296) |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2020-08-17 |