| NPI | 1760760839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704189447) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704189447) |
| Enumeration Date | 2011-07-23 |
| Last Update Date | 2023-03-09 |