| NPI | 1770090409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704301500) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704301500NSA17491) |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2021-02-16 |