| NPI | 1760867154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: HI APRN-2722) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704251481) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2022-01-10 |