| NPI | 1740649680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704287394) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 47042847394) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704287394) | |
| Enumeration Date | 2016-02-21 |
| Last Update Date | 2023-01-24 |