| NPI | 1720495021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 281863) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704254995) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704254995) | |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2020-03-06 |