| NPI | 1730851536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704251762) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 4704251762) |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2021-11-12 |