| NPI | 1750653994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704262007) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704262007) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71007865A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704262007) | |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2023-10-05 |