| NPI | 1760775274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704303276) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A-103707) |
| 363LF0000X Nurse Practitioner, Family (Licence: SD CP000665) | |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2016-07-29 |