| NPI | 1750667069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704256152) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704256152) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5005406) | |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2023-12-18 |